To investigate whether adjuvant treatment with azithromycin results in improvement in lung function in HIV-infected children with chronic lung disease, who are stable on antiretroviral therapy. In addition, the trial will investigate the intervention effect on mortality, exacerbations of lung disease, morbidity and adverse events related to azithromycin treatment .

Objectives

To investigate the intervention effect on exacerbations of lung disease and morbidity

To investigate adverse events related to azithromycin treatment

To determine the effect of azithromycin therapy on antimicrobial resistance in bacteria colonizing the respiratory tract.

To investigate the diversity and composition of the respiratory and gut microbiome in HIV-infected children with and without CLD, and by trial arm.

To investigate the levels of biomarkers between those with and without CLD and the effect of azithromycin on biomarkers of systemic inflammation in HIV-infected children with CLD.

Describe the cardiac symptoms and echocardiograph findings of HIV-infected children with chronic lung disease, who are stable on antiretroviral therapy.

Determine the prevalence of right-sided cardiac dysfunction and/or pulmonary hypertension in HIV-infected children with chronic lung disease, who are stable on antiretroviral therapy, determined by echocardiography at baseline.

To investigate whether adjuvant treatment with azithromycin results in improvement in right-sided cardiac function and/or pulmonary hypertension in HIV-infected children with chronic lung disease, who are stable on ARV, determined by echocardiography at 12 months.

With the contributions from a dedicated and professional staff complement, BRTI has achieved 20 years of continuing growth. From its inception in 1995, the BRTI has strived to become a a centre for excellence in health research and training in Africa. We are confident that the philosophy behind the formation of BRTI, that African scientists must take responsibility for improving their own working environment, was correct. We predict that, in spite of a degree of economic uncertainty in Zimbabwe, the gains that have been made during these years can be consolidated and expanded. We look forward to the future with confidence.